内镜下经椎板间入路腰椎椎间融合术临床研究进展

陈朝波; 钱澍; 赵景玮; 衡伟; 钱济先; 周程沛

doi:10.16766/j.cnki.issn.1674-4152.003766

内镜下经椎板间入路腰椎椎间融合术临床研究进展

doi: 10.16766/j.cnki.issn.1674-4152.003766

空军军医大学第二附属医院骨科，陕西西安 710038

基金项目:

国家自然科学基金项目 81871818

详细信息

通讯作者:
周程沛，E-mail：zhoucpei@126.com

中图分类号: R687.4 R615
计量
- 文章访问数: 14
- HTML全文浏览量: 9
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-04-22
- 网络出版日期: 2024-12-31

Advances in endoscopic translaminar approach for lumbar interbody fusion

Department of Orthopedics, the Second Affiliated Hospital of Air Force Medical University, Xi' an, Shaanxi 710038, China

摘要

摘要: 近年来，随着脊柱内镜技术及微创器械的快速发展，内镜技术在脊柱外科得到广泛应用。从最初的单纯髓核摘除减压，发展到传统开放手术的椎管扩大减压再到现阶段全内镜辅助腰椎融合术，镜下融合逐渐成为治疗腰椎退行性疾病的有效微创术式之一。脊柱全内镜技术有3种不同的手术入路，在临床中因适应证不同而都有所运用。其中经后方椎板间隙入路的内镜辅助腰椎椎间融合术(endoscopic posterior lumbar interbody fusion，Endo-PLIF)近年来在脊柱微创外科领域获得广泛应用且不断优化，通过镜下“过顶”技术可以进行单侧入路双侧减压，进一步扩大其适应证范围，疗效显著，具有创伤小、恢复快、并发症少等优点，已被证实是一种安全可靠的手术方式，但在临床中也相应出现了一些并发症。近年来，医疗器械及生物材料相关领域发展迅速，镜下环锯、镜下磨钻等工具使全内镜技术操作更安全便捷；单侧双通道内镜的出现使术者的学习曲线明显缩短，手术效率进一步提高；可膨胀式融合器、3D打印融合器等让镜下融合有了更好的融合材料选择，且随着数字化、智能化技术的增强，导航、机器人等新技术进一步使镜下融合技术更微创、安全、有效。本文就该技术的发展历程、手术方法、技术特点、疗效及并发症等临床研究现状作以综述，以期为该技术的临床应用及推广提供参考。
- 椎板间入路 /
- 脊柱内镜 /
- 腰椎融合
Abstract: In recent years, the rapid development of spinal endoscopic techniques and minimally invasive instruments has significantly expanded the use of endoscopic technology in spinal surgery. From the initial simple nucleus pulposus removal for decompression, to the extended decompression of the spinal canal in traditional open surgery, and now to the current stage of fully endoscopic-assisted lumbar fusion, microscopic fusion has gradually become one of the effective minimally invasive procedures for the treatment of lumbar degenerative diseases. There are three different surgical approaches used in clinical practice, tailored to specific indications. The endoscopic posterior lumbar interbody fusion (Endo-PLIF) approach was widely used and optimized in the field of spinal minimally invasive surgery in recent years. Through the mirror "over-the-top" technology, Endo-PLIF enables bilateral decompression via a unilateral approach, further expanding the scope of the indications. This method has proven to be highly effective, offering advantages such as minimal trauma, quick recovery, and fewer complications, making it a safe and reliable surgery. However, some complications have also been observed in clinical practice. Medical equipment and biological materials related fields developed rapidly in recent years. Innovations such as the mirror ring saw, mirror drilling tools for the endoscopic technology have more safe and convenient operation, the emergence of unilateral double channel endoscopic shorten the surgeon learning curve, expansion fusion, 3D printing fusion let the mirror fusion have better fusion material choice, and with the enhancement of digital, intelligent technology, navigation, robot, such as new technology further make the mirror fusion technology more minimally invasive, safe and effective. This paper summarizes the development of the technology, surgical methods, technical characteristics, efficacy, complications, and current status of clinical research. The aim is to provide a reference for the clinical application and popularization of the technology.
- Interlaminar approach /
- Spinal endoscopy /
- Lumbar fusion

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参考文献(42)

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